Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer-A Retrospective Cohort Study

被引：6

作者：

Alexander, Andrea ^{[1
,2
]}

Lehwald-Tywuschik, Nadja ^{[1
,2
]}

Rehders, Alexander ^{[1
,2
]}

Rabenalt, Stefanie ^{[2
,3
]}

Verde, Pablo E. ^{[4
]}

Eisenberger, Claus F. ^{[1
,2
,5
]}

Picker, Nina ^{[1
,2
]}

Knoefel, Wolfram Trudo ^{[1
,2
]}

Kienbaum, Peter ^{[2
,3
]}

机构：

[1] Heinrich Heine Univ Dusseldorf, Dept Gen Visceral & Pediat Surg, Univ Hosp, D-40225 Dusseldorf, Germany

[2] Heinrich Heine Univ Dusseldorf, Med Fac, D-40225 Dusseldorf, Germany

[3] Heinrich Heine Univ Dusseldorf, Dept Anesthesiol, Univ Hosp, D-40225 Dusseldorf, Germany

[4] Heinrich Heine Univ Dusseldorf, Coordinat Ctr Clin Trials & Biostat, D-40225 Dusseldorf, Germany

[5] Cologne Holweide Hosp, Dept Visceral Tumor Transplantat & Vasc Surg, D-51067 Cologne, Germany

来源：

CLINICS AND PRACTICE | 2021年 / 11卷 / 03期

关键词：

oncological outcome; staging; recurrence; pancreatic adenocarcinoma; TRADITIONAL PAIN MANAGEMENT; LONG-TERM SURVIVAL; EPIDURAL ANALGESIA; GENERAL-ANESTHESIA; AFFECT RECURRENCE; ADENOCARCINOMA; RESECTION; RISK; PANCREATICODUODENECTOMY; PROSTATECTOMY;

D O I：

10.3390/clinpract11030070

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: In patients with prostatic and breast cancer the application of peridural anesthesia (PDA) showed a beneficial effect on prognosis. This was explained by reduced requirements for general anesthetics and perioperative opioids as well as a lower perioperative stress level. The impact of PDA in patients with more aggressive types of cancer has not been completely elucidated. Here, we analyzed the prognostic influence of PDA on overall survival after surgery as primary in patients that underwent radical resection of pancreatic adenocarcinoma. Methods: Records of 98 consecutive patients were reviewed. In 70 of these cases PDA was applied. Patient characteristics such as demographics, TNM stage, and operative data were retrospectively collected from medical records and analyzed. Survival data were analyzed by Cox's proportional hazard regression model. Results: Overall, no significant prognostic influence of PDA on recurrence or overall survival (p = 0.762, Hazard Ratio [HR] 0.884, 95% confidence interval [CI] 0.398-1.961) was found. However, there was a trend towards a longer overall survival (p = 0.069, HR 0.394, 95% CI 0.144-1.078) associated with PDA in a subgroup of patients with better differentiation of pancreatic adenocarcinoma. Conclusion: The observation of longer survival associated with PDA in our subgroup of patients with better-differentiated pancreatic carcinomas is in line with previous reports on various other less aggressive tumor entities. Our results indicate that PDA might improve the oncological outcome of patients with pancreatic adenocarcinoma.

引用

页码：532 / 542

页数：11

共 49 条

[11] Epidural anesthesia and cancer outcomes in bladder cancer patients: is it the technique or the medication? A matched-cohort analysis from a tertiary referral center [J].